Department of Head and Neck Surgery, Shanxi province Cancer Hospital, China.
Center of Reproduction, Huizhou Central Hospital of Guangdong Province, Guangdong, China.
Int Wound J. 2023 Feb;20(2):251-260. doi: 10.1111/iwj.13867. Epub 2022 Jun 15.
We performed a meta-analysis to evaluate the effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node-negative papillary thyroid carcinoma. A systematic literature search up to April 2022 was performed and 3517 subjects with clinically node-negative papillary thyroid carcinoma at the baseline of the studies; 1503 of them were treated with prophylactic central neck dissection following total thyroidectomy, and 2014 were using total thyroidectomy. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated to assess the effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node-negative papillary thyroid carcinoma using the dichotomous method with a random or fixed-effect model. The prophylactic central neck dissection following total thyroidectomy subjects had a significantly lower surgical site wound infection (OR, 0.40; 95% CI, 0.20-0.78, P = .007) in subjects with clinically node-negative papillary thyroid carcinoma compared with total thyroidectomy. However, prophylactic central neck dissection following total thyroidectomy did not show any significant difference in hematoma (OR, 0.08; 95% CI, 0.43-2.71, P = .87), and haemorrhage (OR, 0.72; 95% CI, 0.26-1.97, P = .52) compared with total thyroidectomy in subjects with clinically node-negative papillary thyroid carcinoma. The prophylactic central neck dissection following total thyroidectomy subjects had a significantly higher surgical site wound infection, and no significant difference in hematoma, and haemorrhage compared with total thyroidectomy in subjects with clinically node-negative papillary thyroid carcinoma. The analysis of outcomes should be with caution because of the low number of studies in certain comparisons.
我们进行了一项荟萃分析,以评估在临床淋巴结阴性甲状腺乳头状癌患者中,甲状腺全切除术后预防性中央颈部清扫术对手术部位伤口感染、血肿和出血的影响。系统文献检索截至 2022 年 4 月,共有 3517 例临床淋巴结阴性甲状腺乳头状癌患者作为研究的基线;其中 1503 例接受甲状腺全切除术后预防性中央颈部清扫术,2014 例采用甲状腺全切除术。使用二项式方法,以随机或固定效应模型计算比值比(OR)和 95%置信区间(CI),以评估甲状腺全切除术后预防性中央颈部清扫术对临床淋巴结阴性甲状腺乳头状癌患者手术部位伤口感染、血肿和出血的影响。与甲状腺全切除术相比,甲状腺全切除术后预防性中央颈部清扫术患者的手术部位伤口感染显著降低(OR,0.40;95%CI,0.20-0.78,P=0.007)。然而,与甲状腺全切除术相比,甲状腺全切除术后预防性中央颈部清扫术在临床淋巴结阴性甲状腺乳头状癌患者的血肿(OR,0.08;95%CI,0.43-2.71,P=0.87)和出血(OR,0.72;95%CI,0.26-1.97,P=0.52)方面无显著差异。与甲状腺全切除术相比,甲状腺全切除术后预防性中央颈部清扫术患者手术部位伤口感染显著增加,而血肿和出血无显著差异。由于某些比较的研究数量较少,因此对结果的分析应谨慎。